How Important Is Sinus Rhythm for Survival of Afib Patients?

In the AFFIRM trial, minimally symptomatic elders with atrial fibrillation (AF) and high stroke risk experienced no more survival benefit with rhythm control (cardioversion plus . . .

In the AFFIRM trial, minimally symptomatic elders with atrial fibrillation (AF) and high stroke risk experienced no more survival benefit with rhythm control (cardioversion plus antiarrhythmic drugs to maintain sinus rhythm [SR]) than with rate control (control of ventricular response to persistent AF with heart-rate goals); Journal Watch Cardiology Jan 10 2003. Because AF and SR were common in both groups during follow-up, SR could have been an important factor in survival.

Now, the AFFIRM investigators have conducted an on-treatment (rather than an intention-to-treat) analysis of their data, accounting for variables (including SR) that changed over time. Of 4060 AFFIRM subjects, 2796 had echocardiographic data available for on-treatment an…

Reviewing Author

Hugh Calkins, MD